[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-208910-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-208910-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","linear-vulvar-lesions-photo-challenge-vestibular-papillomatosis","Linear Vulvar Lesions - Photo Challenge - Vestibular Papillomatosis","","Second-opinion dermatology case describes a 30-year-old woman with congenital absence of the uterus presenting with stable, painful vulvar papules noted since adolescence. Exam showed multiple soft, flesh-colored 1–2 mm filiform papules in a symmetric linear array on the inner bilateral labia minora. Left lesions were treated with low-voltage electrodesiccation with lidocaine, producing light-gray discoloration and good cosmetic and functional outcomes; right-sided lesions were unchanged after one month. Diagnosis: vestibular papillomatosis, a noninfectious anatomic variant.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/linear-vulvar-lesions-photo-challenge-vestibular-papillomatosis/208910/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/linear-vulvar-lesions-photo-challenge-vestibular-papillomatosis/208910.png","ImageObject",300,407,{"name":42,"@type":43},"River Wang","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-09-05",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",18,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What clinical pattern defines vestibular papillomatosis in this case?","Question",{"text":63,"@type":64},"Vestibular papillomatosis presents as multiple soft, flesh-colored, filiform papules arranged symmetrically in a linear array on the inner labia minora, often without significant symptoms but can cause dyspareunia.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the treatment applied to the patient’s lesions and what was the outcome?",{"text":68,"@type":64},"Left medial labia minora papules were treated with low-voltage (3.0 V) electrodesiccation after local anesthesia with 1% lidocaine. The lesions showed light-gray discoloration, and after about one month the patient reported good cosmetic and functional results; the right-sided untreated papules were unchanged.",{"name":70,"@type":61,"acceptedAnswer":71},"Why is vestibular papillomatosis considered noninfectious?",{"text":72,"@type":64},"Although historically associated with human papillomavirus, vestibular papillomatosis is now considered a noninfectious condition, supported by biopsy findings and lack of true koilocytes.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},208910,1788607159,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":80,"read_time":97},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","PHOTO CHALLENGE  \nLinear Vulvar Lesions  \nAbram Beshay, MD; Kanade Shinkai, MD, PhD  \nA 30-year-old woman with congenital absence of the uterus presented to dermatology for a second opinion of vulvar lesions that were first noted during adolescence. The patient reported that the lesions had not changed and were painful during sexual intercourse. The lesions were otherwise asymptomatic, and she had no additional relevant medical history or family history of similar lesions. She denied any history of sexually transmitted infections. Physical examination revealed multiple, soft, flesh-colored, 1-to 2-mm, discrete and coalescing, filiform papules distributed symmetrically in a linear array on the inner aspect of the bilateral medial labia minora. The rest of the mucocutaneous examination was normal.  \nThe lesions on the left medial labia minora were treated with low-voltage (3 .0 V) electrodesiccation following local anesthesia with 1% lidocaine (red arrow),  \nwhile the lesions on the right medial labia minora were left untreated (black arrow) . The clinical image shows the left labia minora approximately 1 month after treatment; the papules on the right labia minora were unchanged from the prior examination.  \nWHAT’S THE DIAGNOSIS?  \na. condyloma acuminatum  \nb. condyloma latum  \nc. molluscum contagiosum  \nd. papulosquamous lichen planus  \ne. vestibular papillomatosis  \nPLEASE TURN TO PAGE E40 FOR THE DIAGNOSIS  \nDr. Beshay was from the School of Medicine, Eastern Virginia Medical School, Norfolk, and currently is from the Department of Dermatology, University of Utah, Salt Lake City. Dr. Shinkai is from the Department of Dermatology, University of California, San Francisco.  \nThe authors report no conflict of interest.  \nCorrespondence: Kanade Shinkai, MD, PhD, UCSF Department of Dermatology, 1701 Divisadero St, 3rd Floor, San Francisco, CA 94115 ([kanade.shinkai@ucsf.edu](kanade.shinkai@ucsf.edu)) .  \nWWW. MDEDGE. COM/DERMATOLOGY VOL. 103 NO. 5 I MAY 2019 E39  \nPHOTO CHALLENGE DISCUSSION  \nTHE DIAGNOSIS:  \nVestibular Papillomatosis  \nVestibular papillomatosis (VP), the female equiva  \nlent of pearly penile papules, is characterized by  \nmultiple papules in a linear array on the labia minora and is considered a normal anatomic variant. It typically presents as monomorphous, soft, flesh-colored, filiform papules that are distributed in a symmetric fashion. In women, the papules present as linear arrays on the inner aspects of the labia minora, whereas in men, they present in a circumferential array along the sulcus of the glans penis.1 Lesions often are asymptomatic but may cause itching, burning, and dyspareunia.2 Previously believed to be associated with human papillomavirus infection,3 VP is now considered a noninfectious condition. Biopsy reveals parakeratosis and perinuclear vacuolization in the absence of true koilocytes.4,5 Dermoscopy and reflectance confocal microscopy have been used to differentiate VP from clinically similar lesions (eg, condyloma acuminatum).6,7 The prevalence of this condition is not well established; however, one study found VP in 1% of women attending genitourinary medicine clinics.3  \nCondyloma acuminatum, known colloquially as genital warts, is a human papillomavirus infection. Lesions tend to be painless and firm and are distributed asymmetrically with a cauliflowerlike appearance.1 Condyloma latum, found in secondary syphilis, is characterized by papules that are pale, smooth, flat topped, and moist.8 Molluscum contagiosum is an infection caused by apoxvirus presenting with flesh-colored, dome-shaped papules with central umbilication.9 The lesions of papulosquamous lichen planus are violaceous polygonal papules that affect the clitoral hood and labia minora and may cause pruritus. The cause of lichen planus is unknown; however, clinically similar lesions may occur in a lichenoid drug eruption due to certain medications.  \nVestibular papillomatosis typically does not require treatment, except in ","cbCaihfLFhbt4ARu","https://ap.wps.com/l/cbCaihfLFhbt4ARu","pdf",506169,"English","# Photo Challenge\n## What’s the Diagnosis?\n## Photo Challenge Discussion\n### The Diagnosis: Vestibular Papillomatosis","[{\"question\":\"What clinical pattern defines vestibular papillomatosis in this case?\",\"answer\":\"Vestibular papillomatosis presents as multiple soft, flesh-colored, filiform papules arranged symmetrically in a linear array on the inner labia minora, often without significant symptoms but can cause dyspareunia.\"},{\"question\":\"How was the treatment applied to the patient’s lesions and what was the outcome?\",\"answer\":\"Left medial labia minora papules were treated with low-voltage (3.0 V) electrodesiccation after local anesthesia with 1% lidocaine. The lesions showed light-gray discoloration, and after about one month the patient reported good cosmetic and functional results; the right-sided untreated papules were unchanged.\"},{\"question\":\"Why is vestibular papillomatosis considered noninfectious?\",\"answer\":\"Although historically associated with human papillomavirus, vestibular papillomatosis is now considered a noninfectious condition, supported by biopsy findings and lack of true koilocytes.\"}]","Linear Vulvar Lesions - Photo Challenge - Vestibular Papillomatosis | PDF"]